What isDissociative Identity Disorder?Dissociative Identity Disorder (DID) Also called Multiple Personality Disorder. Described as a psychiatric diagnosis in which a person has two or more alternating personalities Causes an inability to recall personal information or activities relating to a personality or personalities. Mild dissociation Very common among the general population May be described as daydreaming or “running on autopilot.” Can be triggered by stress, and is thought by some to be a way for the mind to distance itself from experiences that are too difficult for it to process. 
DID in Real Life Eleven-ManIn some cases, certain identities can interact with one another internally. An article in Time Magazine refers to a patient named Robert Oxnam, who was diagnosed with DID. He has a total of 11 different personalities, many of them known to one another but not to Oxnam himself. 
What is the cause of the Narrators DID? Theoretically, the disorder is linked with extremely high stress levels, often associated with traumatic experiences, and a unique ability to sever conscious connections with memories. The narrator experiences this in the form of insomnia. While he believes he is just laying awake at night, his alternate personality is actually making soap. A large amount of patients reportedly suffer from child abuse.Both the narrator and Tyler allude to the possibility that they were abused at some point, and at separate times, they state that their fathers left them when they were young.
Diagnosis To help diagnose dissociative disorders, a psychologicinterview using special questionnaires made specifically to identify dissociative disorders is conducted, along with a medical examination that may physically determine the cause of some symptoms. In some cases, the patient may need to be sedated orhypnotized in order to relax the person and draw out the other personalities and repressed information. 
SymptomsThere are several symptoms related to DID, which include : Varying levels of functionality Time distortions, time lapses, and amnesia Depersonalization and Derealization Fugue States Depression Sudden anger/Irritability Insomnia Hearing the voices of other personalitiesThe narrator experiences many of these symptoms throughout the movie.
Depersonalization Depersonalization Occurs when a person experiences a persistent or recurring feeling of being detached from his or her body and/or thoughts. Often referred to as an “out-of- body experience.” Unlike patients with a psychotic disorder, depersonalized patients are aware that their unreal experiences are, in fact, not real. 
DerealizationDerealization can be described as a change in the way one perceives and experiences the external world, in a way that makes the world seem unfamiliar or dream-like. Some patients describe derealization as a sense of seeing the world from behind an immaterial barrier, as if it was foggy or very far away. Unlike depersonalization, in which one feels detached from his/her body, derealization deals with a feeling of detachment from the outside world. It is not a standalone disorder, but rather a symptom of numerous psychiatric disorders. It often co-occurs with insomnia and severe stress. This symptom appears near the beginning of Fight Club, and the narrator attributes it to his amnesia, stating “With insomnia, nothings real. Everythings far away.”
Fugue State A fugue state, known formally as a dissociative fugue, is one or more episodes of amnesia relating to a persons identity. During fugue states,patients cannot recall their past and lose their identity, and as a result, often develop a new one. They usually set out on sudden, unexpected travels. Fugue states can last from a few hoursto more than a few months, and patients may wander very far from their homesand families, assuming a new job under a new identity. 
Fugue State (Contd) People who are in a fugue state are unaware of any apparent change in their lives. However, they may become confused about their identity, or their original memories may eventually return. If this occurs, people usually become extremely distressed and may confront others, causing intense conflict, as the patients must face what they left behind.  In Fight Club, the narrator constantly experiences fugue states, andeven begins noticing gaps in his memory. He also begins to wake up in a different time and place than when he fell asleep, and becomes very suspicious of his association with himself and Tyler.
How is it acquired? While there is no proven cause of DID, studies have shown that the number of diagnoses has risen. DID frequently occurs alongside other psychiatric issues, such as insomnia and anxiety disorders. Studies have also shown that DID is clearly not exclusive to Americans, and can be diagnosed outside of the United States if the symptoms are sought after.According to the International Society for the Study of Trauma and Dissociation, about 1% of the total population suffer from this disorder, and it is speculated that about 7% have untreated dissociative disorders. 
Treatment and PreventionSafety is the first priority. Supportive care, drug treatment, and long-term integration of identity states are the standard methods of treatment. Many treatments aim to facilitate cooperation and collaboration among the identities. Therapy is used to reconnect and rehabilitate the personalities to restore social functioning. In serious cases, a change in the very structure of the patients self-consciousness may be needed.
Contact/Help GroupsSince DID is a generallyrare disorder, there are no formal organizations or support groups for this condition. However, a few online groups claiming to have DID have come together to share their stories and offer advice to others with this disorder.
The Narrators ExperienceBegins with his insomnia. The narrator is not awareAttends several support groups that Tyler is his alternate for dying people, and he finds a personality. release in crying with them, The two begin to use which allows him to sleep. physical violence as a newA fellow “faker” causes his form of “release.” insomnia to relapse. More and more, the narratorAs a result, the narrator begins sees Tyler projected into the interacting with an alter ego, world, giving the illusion Tyler Durden. that he is a separate beingUnlike the passive, antisocial and influences the world personality of the narrator, independently. Tyler is much more eloquent and animated.
The Narrators Experience (Contd) However, his alter ego, Tyler, is very smart and aware of hisexistence as an alternate personality. Tyler sets up the events inthe movie to occur in a way that wouldnt reveal to the narrator that the two of them were the same person.
Mind Over MatterEventually, the narrator realizes that he and Tyler are the same person, and the two personalities begin struggling for dominance. In his desperation, the narrator shoots himself in the cheek, staging a sort of mock suicide that erases Tyler Durdens personality from his mind.
Real or Reel?While the storyline is farfetched, the creation and actions of thenarrators alter ego can easily be categorized as DID. The narrators unconscious, international trips under a different identity wouldundoubtedly be described as a dissociative fugue, and the insomnia that arguably begins his alter egos actions is, for the most part, accurately portrayed. The method which is used to cure his DID, however, would be considered very radical. It is rumored at one point in the movie that the narrators alter ego, and thus the narrator himself, was born in a mental institution and sleeps only one hour every night, implying that the narrator himself may have had a history of mental issues. This is further supported by the fact that the narrator apparently had fugue states since before the beginning of the movie.
Sources Mercks Manuals for Healthcare Professionals, 2009. Web. 22, March 2011. http://www.merckmanuals.com/professional/sec15/ch197/ch197e.html Mayo Clinic, 2011. Web. 8, April 2011. http://www.mayoclinic.com/health/dissociative- disorders/DS00574/DSECTION=symptoms “Meet Robert. And Tommy And Bobby and Wanda ...” Time Inc. 2005. Web. 22, March 2011. http://www.time.com/time/magazine/article/0,9171,1112834,00.html Mercks Manuals Home Edition, 2009. Web. 22, March 2011. http://www.merckmanuals.com/home/sec07/ch106/ch106e.html Prime Health Channel, 2010. Web. 8, April 2011. http://www.primehealthchannel.com/dissociative-identity-disorder-symptoms- diagnosis-treatment-and-statistics.html